GOP should focus on drug costs, not Obamacare repeal

President-elect Donald Trump and Republicans in Congress are intent on following through on their promise to repeal the Affordable Care Act.

If they succeed, it will be a blunder, one that will strike especially hard in California. A flat-out repeal could cost California $21 billion and threaten coverage for almost 5 million Californians who receive coverage through the Medi-Cal expansion or benefit from subsidized insurance through Covered California, according to Health Access, a health care consumer advocacy organization.

The Central Valley would be particularly hard hit. In Elk Grove Republican Tom McClintock’s district, 74,550 people benefit from the Medi-Cal expansion or subsidized health care through the Affordable Care Act. In Turlock Republican Jeff Denham’s district, nearly 110,000 residents directly benefit from Obamacare. In the Kern and Tulare counties district represented by House Majority Leader Kevin McCarthy, 81,500 people get subsidized coverage, Health Access reports.

Instead of attacking a program that has worked to provide coverage to 20 million previously uninsured Americans, Congress should fix the problems with Obamacare and pay particular attention to what drives up the cost of health care. One place to start is with the high cost of drugs.

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“Drug companies are exploiting lax laws and regulations that enable exorbitant prices,” Tom Epstein, a retired Blue Shield insurance executive who worked on the Affordable Care Act, wrote in an op-ed in The Sacramento Bee on Sunday. “The federal government grants monopolies to manufacturers of brand drugs even if their products don’t provide better value than existing therapies, while generic drug companies have increased prices by triple digits when they recognize they have no competition.”

Many drugs extend lives and relieve suffering. But too many drugmakers are focused on shareholders and profits. To generate sales, nine drugmakers spent $100 million or more each on ads in 2016 to persuade the public of the need for various pills, the nonpartisan health news website Stat reports. Altogether, Stat reports, there were 1.3 million ads aired on national television in 2016, at a multibillion-dollar cost that consumers ultimately shoulder.

Reining in drug costs won’t be easy, not in what Trump calls “the swamp.” The nonpartisan Center for Responsive Politics calculates that since 1998, drugmakers have been the biggest spender on lobbying in Washington, D.C., at $3.45 billion – $1 billion more than the next largest industry, insurance.

Earlier in the year, drug company lobbyists derailed legislation to increase drug price transparency. But drug companies should not take their victories as votes of confidence. Senate Health Committee Chairman Ed Hernandez, D-West Covina, will be back at it with a similar bill in 2017, having introduced Senate Bill 17. And voters could be more amenable to a targeted, less complicated initiative in 2018.

In Congress, Republicans think they will have little choice but to repeal the Affordable Care Act. They’ve voted dozens of times to repeal President Barack Obama’s signature domestic policy achievement.

Some members may even think they will achieve short-term political gain by dismantling the law. But the high cost of health care is the issue. And it will remain too high until responsible policymakers focus on the causes.